<?php include 'login/Restrito.php';?>
<form method="post" action="reclamacao/ReclamacaoCadastrar.php" >
             <br />
             <h3 align="center">Registrar nova Reclamação</h3>
			  	<hr color="#0066FF" size="3px">
			    <br />
			 <div align="center" style="min-height: 350px; width:auto">
             <table width="700px" align="center">
              <tr>
          		<td>Paciente - CPF</td>
          		<td><select name="paciente" >
          			<option selected >Selecione...</option>
          			<?php
							require "banco/ConexaoBanco.php";
							$query = mysql_query("SELECT * FROM paciente");
							while($lista = mysql_fetch_array($query)) { ?> 
							<option value="<?php echo $lista['id_paciente']; ?>"><?php echo $lista['p_nome'] .' - '. $lista['p_cpf']; ?></option>
						<?php } mysql_close();?>
          		</select>
          	
	          	</td>
	          </tr>
              <tr>
                    <td align="left">Motivo ou Queixa</td>
                    <td><textarea name="motivo" rows="5" cols="61" style="resize:none;"></textarea></td>
                </tr>
                  <tr>
                    <td align="left">Descrição dos fatos</td>
                    <td><textarea name="desc" rows="5" cols="61" style="resize:none;"></textarea></td>
                </tr>
                  <tr>
                    <td>&nbsp;</td>
                    <td align="center"><input type="submit" value="Registrar" class="botao" name="enviar"/></td>
                </tr>
              </table>
              </div>
        </form> 